Table 1.
Study sample characteristics by presence of a mental health disorders/symptoms (dis/sx) with and without adverse childhood experiences (ACEs) and absence of all mental health conditions
| Overall Study >age 21 |
MH dis/sx. No ACE |
No MH dis/sx. No ACE |
SMD | MH dis/sx. + ACE |
No MH dis/sx. +ACE |
SMD | SMD (average) |
|
|---|---|---|---|---|---|---|---|---|
| Sample Size (n) |
7,852,081 (100%) |
1,552,726 (19.8%) |
6,219,285 (79.2%) |
46,277 (0.59%) |
33,793 (0.43%) |
|||
| Age at first visit, y, mean/(SD) | 6.4 (5.8) | 6.5 (5.6) | 6.4 (5.9) | 0.006 | 6.3 (5.4) | 4.3 (4.9) | 0.388 | 0.213 |
| Age at first MH visit, y, mean/(SD) | 8.5(5.5) | 8.6 (5.5) | NA | NA | 8.5 (5.3) | NA | NA | NA |
| Follow-up duration, y, mean (SD) | 3.0 (3.6) | 5.1 (4.0) | 2.4 (3.2) | 0.731 | 7.0 (4.1) | 4.1 (3.9) | 0.725 | 0.645 |
| Sex | 1.07 | 0.067 | 0.264 | |||||
| Female |
3,759,392 (47.9%) |
674,607 (43.4%) |
3,034,232 (48.8%) |
28,632 (61.9%) |
21,921 (64.9%) |
|||
| Male |
4,091,978 (52.1%) |
878,010 (56.5%) |
3,184,466 (51.2%) |
17,643 (38.1%) |
11,859 (35.1%) |
|||
| Race and Ethnicity | 0.155 | 0.118 | 0.297 | |||||
| Non-Hispanic White |
4,020,014 (51.2%) |
835,851 (53.8%) |
3,146,217 (50.6%) |
22,493 (48.6%) |
15,453 (45.7%) |
|||
| Non-Hispanic Black |
1,074,630 (13.7%) |
247,805 (16.0%) |
804,519 (12.9%) |
13,269 (28.7%) |
9,037 (26.7%) |
|||
| Hispanic |
1,243,842 (15.8%) |
231,991 (14.9%) |
1,001,259 (16.1%) |
5,428 (11.7%) |
5,164 (15.3%) |
|||
| Asian/Pacific |
351,196 (4.5%) |
55,262 (3.6%) |
294,947 (4.7%) |
552 (1.2%) |
435 (1.3%) |
|||
|
Other/ Unknown |
1,162,399 (14.8%) |
181,817 (11.7%) |
972,343 (15.6%) |
4,535 (9.8%) |
3,704 (11%) |
|||
| Year of first visit | 0.387 | 0.349 | 0.387 | |||||
| 2010 |
1,369,494 (17.4%) |
395,255 (25.5%) |
951,877 (15.3%) |
16,715 (36.1%) |
5,647 (16.7%) |
|||
| 2011 |
638,125 (8.1%) |
137,324 (8.8%) |
492,450 (7.9%) |
5,260 (11.4%) |
3,091 (9.1%) |
|||
| 2012 |
534,633 (6.8%) |
110,516 (7.1%) |
417,775 (6.7%) |
3,839 (8.3%) |
2,503 (7.4%) |
|||
| 2013 |
509,932 (6.5%) |
105,812 (6.8%) |
398,509 (6.4%) |
3,335 (7.2%) |
2,276 (6.7%) |
|||
| 2014 |
617,351 (7.9%) |
127,413 (8.2%) |
484,523 (7.8%) |
3,099 (6.7%) |
2,316 (6.9%) |
|||
| 2015 |
584,292 (7.4%) |
113,236 (7.3%) |
465,769 (7.5%) |
2,846 (6.1%) |
2,441 (7.2%) |
|||
| 2016 |
575,099 (7.3%) |
108,133 (7.0%) |
461,876 (7.4%) |
2,512 (5.4%) |
2,578 (7.6%) |
|||
| 2017 |
557,137 (7.1%) |
103,608 (6.7%) |
448,866 (7.2%) |
2,282 (4.9%) |
2,581 (7.6%) |
|||
| 2018 |
547,859 (7.0%) |
97,290 (6.3%) |
446,173 (7.2%) |
1,931 (4.2%) |
2,465 (7.3%) |
|||
| 2019 |
501,325 (6.4%) |
83,364 (5.4%) |
414,133 (6.7%) |
1,547 (3.3%) |
2,281 (6.7%) |
|||
| 2020 |
389,391 (5.0%) |
60,941 (3.9%) |
325,308 (5.2%) |
1,214 (2.6%) |
1,928 (5.7%) |
|||
| 2021 |
475,557 (6.1%) |
61,416 (4.0%) |
411,161 (6.6%) |
1,002 (2.2%) |
1,978 (5.9%) |
|||
| 2022 |
469,455 (6.0%) |
42,587 (2.7%) |
424,746 (6.8%) |
624 (1.3%) |
1,498 (4.4%) |
|||
| 2023 |
82,431 (1.0%) |
5,831 (0.4%) |
76,319 (1.2%) |
71 (0.2%) |
210 (0.6%) |
|||
| Insurance type at first visit | 0.165 | 0.161 | 0.511 | |||||
|
Private/ Commercial |
3,548,463 (45.2%) |
607,246 (39.1%) |
2,930,195 (47.1%) |
5,676 (12.3%) |
5,346 (15.8%) |
|||
| Public |
2,879,351 (36.7%) |
618,049 (39.8%) |
2,215,948 (35.6%) |
25,609 (55.3%) |
19,745 (58.4%) |
|||
|
Other/ Unknown |
1,424,267 (18.1%) |
327,431 (21.1%) |
1,073,142 (17.3%) |
14,992 (32.4%) |
8,702 (25.8%) |
|||
| Number of body systems, (mean/SD) | 0.6 (1.2) | 1.4 (1.9) | 0.4 (0.8) | 0.638 | 1.5 (2.0) | 0.4 (0.8) | 0.072 | 0.463 |
| Number of chronic physical health condition body systems 1 | 0.727 | 0.813 | 0.542 | |||||
| 0 | 64.5% | 41.0% | 70.6% | 37.3% | 71.2% | |||
| 1 | 23.1% | 28.3% | 21.8% | 27.4% | 19.9% | |||
| 2 | 7% | 14.2% | 5.2% | 15.9% | 6.0% | |||
| 3+ | 5.3% | 16.5% | 2.4% | 19.5% | 3% | |||
| PEDSnet Health Sites, n/ (%) | 0.282 | 0.358 | 0.625 | |||||
| A |
1,409,799 (18%) |
302,523 (19.5%) |
1,098,750 (17.7%) |
4,393 (9.5%) |
4133 (12.2%) |
|||
| B |
534,446 6.8% |
100,103 (6.4%) |
430,555 (6.9%) |
2,484 (5.4%) |
1,304 (3.9%) |
|||
| C |
1,131,781 (14.4%) |
209,940 (13.5%) |
913,898 (14.7%) |
4,282 (9.3%) |
3,661 (10.8) |
|||
| D |
981,695 (12.5%) |
214,429 (13.8%) |
745,523 (12.0%) |
12,086 (26.1%) |
9,657 (28.6%) |
|||
| E |
906,216 (11.5%) |
251,497 (16.2%) |
632,325 (10.2%) |
15,528 (33.6%) |
6,866 (20.3%) |
|||
| F |
534,189 (6.8%) |
94,104 (6.1%) |
439,468 (7.1%) |
351 (0.8%) |
266 (0.8%) |
|||
| G |
739,150 (9.4%) |
98,932 (6.4%) |
635,029 (10.2%) |
2,067 (4.5%) |
3,122 (9.2%) |
|||
| H |
636,377 (8.1%) |
147,263 (9.5%) |
480,718 (7.7%) |
4,241 (9.2%) |
4,155 (12.3%) |
|||
| I |
978,428 (12.5%) |
133,935 (8.6%) |
843,019 (13.6%) |
845 (1.8%) |
629 (1.9%) |
Note: Standardized Difference(SMD) = the statistic used to identify meaningful differences in two distributions (e.g., patients with mental health disorders/symptoms and no ACEs versus patients with no MH disorders/symptoms and no ACEs; patients with ACEs alone versus patients with ACEs + MH disorders/symptoms). SMD average is an average of all possible pairwise SMD’s. A difference of > 0.20 is a meaningful effect size
N = Sample size; y- Year; SD = Standard Deviation
Race and Ethnicity = self-identified
1 Using the Pediatric Medical Complexity Algorithm(39), diagnosis terms were assigned to body systems (e.g., cardiac, endocrine, etc.), excluding the mental health condition category
PEDSnet Health Sites = anonymized A through I
MH = Mental Health
dis = disorder(s)
sx = symptom(s)
ACEs = Adverse Childhood Experience(s)